Caregiver’s Guide
As a caregiver for someone with pulmonary arterial hypertension (PAH), your main concern is making PAH therapy as smooth as possible. The following Site Pain Management Flashcard and testimonials are designed to help you better provide optimal care for someone with PAH. You can download the Site Pain Management Flashcard by clicking on the link for the PDF file.
Site Pain Management Flashcard
This useful flashcard provides detailed information on helping to manage the pain and inflammation of subcutaneous (SC) continuous drug infusion. Included are reminders on managing patients' expectations, information on injection site pain and administration site selection, and a host of pain-management techniques that others have found useful.
Join other caregivers at The PEER Network
The PEER Network (Patients Exchanging Experiences with REMODULIN) is a unique program that connnects people who are considering taking REMODULIN, or who have recently started therapy, with experienced REMODULIN patients — called PEER Mentors. Caregivers can learn from those who have extensive REMODULIN experience and share their own experiences. The PEER Network allows for the exchange of private phone calls and one-to-one e-mails through a secure Web-based system and also offers a supportive group speaker program. Simply visit www.peernetwork.net to learn more.
REMODULIN® (treprostinil) Injection
Indication
REMODULIN is indicated for the treatment of pulmonary arterial hypertension (PAH) in patients with NYHA Class II-IV symptoms to diminish symptoms associated with exercise. It may be administered as a continuous subcutaneous infusion or continuous intravenous infusion; however, because of the risks associated with chronic indwelling central venous catheters, including serious blood stream infections, continuous intravenous infusion should be reserved for patients who are intolerant of the subcutaneous route, or in whom these risks are considered warranted.
In patients with PAH requiring transition from Flolan® (epoprostenol sodium), REMODULIN is indicated to diminish the rate of clinical deterioration. The risks and benefits of each drug should be carefully considered prior to transition.
Important Safety Information:
Chronic intravenous infusions of REMODULIN are delivered using an indwelling central venous catheter. This route is associated with the risk of blood stream infections (BSI) and sepsis, which may be fatal. Therefore, continuous subcutaneous infusion is the preferred mode of administration. REMODULIN should be used only by clinicians experienced in the diagnosis and treatment of PAH. REMODULIN is a potent pulmonary and systemic vasodilator. It lowers blood pressure, which may be further lowered by other drugs that also reduce blood pressure. REMODULIN inhibits platelet aggregation and therefore, may increase the risk of bleeding, particularly in patients on anticoagulants. REMODULIN dosage adjustment may be necessary if inhibitors or inducers of CYP2C8 are added or withdrawn. Initiation of REMODULIN must be performed in a setting with adequate personnel and equipment for physiological monitoring and emergency care. Therapy with REMODULIN may be used for prolonged periods, and the patient’s ability to administer REMODULIN and care for an infusion system should be carefully considered. REMODULIN dosage should be increased for lack of improvement in, or worsening of, symptoms and it should be decreased for excessive pharmacologic effects or for unacceptable infusion site symptoms. Abrupt withdrawal or sudden large reductions in dosage of REMODULIN may result in worsening of PAH symptoms and should be avoided. Caution should be used in patients with hepatic or renal insufficiency.
The most common side effects of REMODULIN included those related to the method of infusion. For subcutaneous infusion, infusion site pain and infusion site reaction (redness and swelling) occurred in the majority of patients. These symptoms were often severe and could lead to treatment with narcotics or discontinuation of REMODULIN. For intravenous infusion, line infections, sepsis, arm swelling, tingling sensations, bruising, and pain were most common. General side effects (>5% more than placebo) were diarrhea, jaw pain, vasodilatation, and edema.
For more information about REMODULIN, please see the Full Prescribing Information.
